Randomized blinded trial comparing NOTES with laparoscopy reveals no difference in immunologic parameters
Background: Natural Orifice Transluminal OrificeSurgery (NOTES) is being investigated for human use as a new minimally invasive procedure. We compared NOTES with the current gold standard laparoscopy.Hypothesis: Animals undergoing NOTES will reveal greater hemodynamic instability due to uncontrolled insufflation pressures. No difference in the immunologic impact as measured by Interleukin-1b will be realized.Design: Randomized blinded… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Optimizing Magnetically Anchored Camera, Light Source, Graspers, and Cautery Dissector for Transvaginal NOTES Cholecystectomy
Introduction: We previously reported successful transvaginal NOTES cholecystectomy in a porcine model using a Magnetic Anchoring and Guidance System (MAGS). The purpose of this study was to further optimize MAGS instruments for this procedure.Methods: Preliminary in-vivo testing (n=1) and complete non-survival procedures (n=3, 33-34kg) were performed in pigs. Through a vaginotomy created under direct vision,… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Open label, prospective, randomized controlled trial of endoscopic duodenal jejunal bypass sleeve versus low calorie diet for weight loss.
Background: The duodenal jejunal bypass sleeve (DJBS) has been shown to achieve a completely endoscopic duodenal exclusion without the need for stapling or anastomosis. This report consists of the first randomized controlled trial for weight loss. Methods: In a 12-week, open label, prospective, randomized study, patients received either a low fat diet and the DJBS… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Omentoplasty for Gastrotomy Closure After NOTES Procedures
Introduction: The antibacterial and healing properties of the greater omentum have yet to be used in translumenal access closure of NOTES procedures. Objective: To evaluate the feasibility, efficacy and tolerance of the incorporation of a flap of greater omentum in gastrotomy closure sites. Methods and procedures: Survival experiments were performed in nine 40-kg pigs under… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Novel Endoscope Fixation for Natural Orifice Transgastric Cholecystectomy
Introduction: Transgastric, scar-free cholecystectomy is an electrifying prospect. Unfortunately, multiple barriers have hampered early investigation into this technique. Some of the principle obstacles encounered are; a gastroscope which is too flexible for adequate dissection, a surgical site that is located at almost 180° from the direction of scope insertion requiring retro-flexion and significant scope looping,… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
NOTES Transvaginal Hernia Repair with Alloderm Mesh
Introduction: Natural Orifice Translumenal Endoscopic Surgery (NOTES) is a new technique for completing operations by using the body’s natural orifices. Patients with abdominal wall hernias are one subset of patients that may benefit from NOTES therapy as standard surgical techniques may create more hernias for these patients. Methods: Two 35 kg pigs underwent a ventral… Continue Reading
- Topic:
- Endolumenal / NOTES
NOTES: Transvaginal Cholecystectomy with Assisting Articulating Instruments
Introduction: Transvaginal cholecystectomy has been performed at several institutions using the hybrid NOTES techniques. Methods: The patient is a 42 year old female with symptomatic cholelithiasis. After obtaining informed consent, the patient was taken to the operating room for transvaginal cholecystectomy. A single 5 mm laparoscope was placed at the umbilicus, followed by a 15mm… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
NOTES sigmoid resection
Bakground:NOTES Colonic resection is difficult to perform because of the need for exposure, dissection, vascular control and anastomosis. The aim of the present study was to evaluate the feasibility and early results of combined transgastric-transrectal NOTES sigmoidectomy.Materials and Methods:A two-week survival study was undertaken to evaluate the combined trangastric-transrectal approach for sigmoidectomy in 5 mini-pigs.… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
NOTES Pancreatic Pseudocystgastrostomy: a Human NOTES Anastomosis
Introduction: Natural orifice transluminal endoscopic surgery (NOTES) is a technique where an operation is performed across the lumen of a hollow viscus without the aid of an abdominal incision. Much of the early work in NOTES has utilized a transgastric approach due to ease of endoscope passage through the mouth. Pancreatic pseudocysts have long been… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
NOTES Ovariectomy in Dogs–A Feasibility Study
NOTES procedures were performed in 5 dogs by creating access to the abdominal cavity via the stomach using a flexible endoscope and guide wire, needle knife electrode, and balloon dilation catheter. Following inflation with air, an electrocautery snare was used to coagulate and cut tissue to remove the ovaries. The ovaries were then extracted, visually… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
NOTES: new concepts in gastric closure
Introduction:Closure of the gastrotomy, when performing transgastric procedures, is one of the most challenging steps. Several methods of gastric closure have been described in the literature but to date there is still a lack of a rapid, simple and effective device. The aim of this study was to evaluate the technical feasibility, efficacy and safety… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
NOTES: Cadaveric Rendezvous Hybrid Small Bowel Resection
Natural Orifice Translumenal Endoscopic Surgery (NOTES) is an emerging field in minimally invasive surgery that is driving the development of new technology and techniques. Before NOTES gains widespread popularity, it must be proven to be a safe and efficacious technique. There are several proposed benefits of the NOTES approach. Among these benefits are a potentially… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
New Technique for Gastrotomy Closure in NOTES and its Comparison with Endoclips
INTRODUCTION: Numerous experimental studies have been conducted to evaluate, explore, and develop Natural Orifice Transluminal Endoscopic Surgery (NOTES). The results have been varied ranging from mediocre to excellent. The most common challenge and perhaps the main limiting factor for the progress of NOTES has been the issue of adequate and effective gastrotomy closure. We describe… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Natural Orifice Translumenal Endoscopic Surgery with a Miniature in Vivo Surgical Robot
Introduction: The application of flexible endoscopy tools for Natural Orifice Translumenal Endoscopic Surgery (NOTES) is constrained due to limitations in dexterity, instrument insertion, navigation, visualization, and retraction. Miniature endolumenal robots that are not constrained by the natural orifice can mitigate these constraints through providing a stable platform for visualization and dexterous manipulation. This video demonstrates… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Natural Orifice Translumenal Endoscopic Surgery (NOTES) Peritoneoscopy Versus Laparoscopy to evaluate Intra-Abdominal Pathology in a Porcine Model
Background: The decision to operate on the intensive care patient with a questionable abdominal source of sepsis continues to prove difficult despite advancements in radiographic imaging. We believe a bedside trans-gastric NOTES exploration could be a valuable diagnostic tool in this setting.Methods: An acute, non-survival, study of 8 pigs was performed. Pigs were randomized to… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES